Traumatic impact of the skeleton may require extensive surgery to re-align fragmented skeletal features. Although any alignment of bone fragments requires a degree of precision, restoring the form and function of the bone fragments in the craniofacial skeleton is particularly challenging because of the strict tolerances required.
During conventional craniofacial surgery, a plastic surgeon restores the form and function of the bone fragments in the craniofacial skeleton by first exposing all the fragments (e.g., by removing any fleshy tissue surrounding the fragments). This visualization is necessary to determine how the bone fragments should fit together for a reduction of the fracture(s). Next, the fracture(s) are reduced by bringing the displaced or broken bones to a desired configuration position (e.g., returned back to their pre-fractured positions). The reduction is typically performed by manually manipulating the bone fragments to the desired configuration. Once the fracture(s) are reduced, the aligned bone fragments are maintained in this configuration with a prosthesis.
The prosthesis may comprise of, for example, rigid screws and plates and/or bone grafts, which are used to maintain the aligned bone fragments together. The screws, plates, and/or grafts may be made of metals or synthetic materials, such as plastics. Typically, the decision as to the type and configuration (e.g., dimensions, form, rigidity, etc.) of the prosthesis is made during the surgical procedure such that the surgeon has a visual depiction of the contours of the fragments once aligned. The surgeon can then use this visual depiction to determine the type and configuration of the prosthesis. A machine room may be located in close proximity to the operating room to fabricate the necessary prosthesis during the operation.
There are several problems with this current, standard approach. To visualize the fragments (e.g., in order to align them and to determine the prosthesis to use) necessitates their exposure, which reduces the blood supply to the bodily area of the fracture. To improve the blood supply, the surgeon can decrease the extent of dissection. However, with decreased dissection, the surgeon is not able to visualize the entire fracture, which could lead to potential mal-alignments of the bone fragments. Further, because the surgeon does not determine the type and configuration of the prosthesis to use until the surgery is underway, the surgery is prolonged while the prostheses is configured or manufactured appropriately. This results in extended periods of time in which the patient remains anesthetized and dissected, increasing the chance of surgical complications and tying up valuable surgical resources such as surgical clean rooms, surgeons, nurses, and anesthesiologists, etc.